We describe a case of sinonasal lymphoma in a child with immunosuppression who presented with symptoms of complicated acute rhinosinusitis with orbital abscess. Despite appropriate medical and surgical therapies, patient developed intracerebral extension. Histopathology confirmed EBV-positive B-cell lymphoma and this was thought to be related to Immunosuppression-Associated Lymphoproliferative Disorders (IALD). Disease progression halted and later regressed with appropriate chemotherapy. Although rare, this case highlights the importance of having high index of suspicion and consideration of all possibilities including lymphoma in immunosuppressive patient. In this report, we also present review of literature relating to IALD with sinonasal manifestation.